大腸灌洗系統使用於慢性便秘病人及大腸鏡檢查之效果及安全性評估

The Effectiveness and Safety of Colon Irrigation for Patients with Chronic Constipation and before Colonoscopic Examination

黃庭章(Ting-Chang Huang) ； 林志陵(Chih-Lin Lin) ； 李熹昌(Hsi-Chang Lee) ； 陳冠仰(Kuan-Yang Chen) ； 廖麗瑛(Li-Ying Liao) ； 王鐘貴(Chung-Kwe Wang)

《北市醫學雜誌》 14卷1期 (2017/03) Pp. 1-12

https://doi.org/10.6200/TCMJ.2017.14.1.01

摘要

目的：大腸灌洗系統係應用在因醫療用途而必須進行大腸灌洗時，例如慢性便秘病患或內視鏡檢查前之腸道清潔準備。本研究之主要目的在於評估大腸灌洗系統安全性、使用效果、不適感和使用者滿意度。方法：本研究招募68 名受試者，其中64 名為無須進行大腸鏡檢查之一般受試者，每名受試者灌洗3 次，以及抽血3 次以檢驗體內電解質（鈉離子與鉀離子）狀況，合計灌洗及抽血各192 人次。另4 位受試者為需進行大腸鏡檢查，願意以大腸灌洗作為大腸鏡檢查前之腸道清潔準備，每名灌洗2 次，合計8 次，抽血檢驗體內電解質（鈉離子與鉀離子）狀況1 次，合計4 次。總計68 名受試者灌洗200 次，抽血196 次。結果：研究結果顯示一般受試者192 次灌洗中，受試者自評使用效果佳，且灌洗當天有高達96% 以上之受試者成功排便。在接受大腸鏡檢查之4 名受試者中，以優、良、可、差四級標準透過大腸鏡檢查醫師評估，結果4 名受試者中有3 名被評為良，可直接執行大腸鏡檢查。不適感部分，在200 人次的大腸灌洗，皆未出現頭痛、頭暈、噁心、嘔吐、腹部劇痛、肛門感染等問題，只有少數受試者，出現因腸蠕動所產生的輕微腹部疼痛，但疼痛時間不長，且皆在受試者能忍受範圍內。結論：對於慢性便秘的病患，大腸灌洗系統是有效而且安全，受試者對於使用效果及不適感有很高的滿意度。此外，對於大腸鏡檢查，灌洗系統也可以達到良好的清腸程度。

關鍵字

大腸灌洗 ； 便秘 ； 電解質 ； 安全性 ； 滿意度

並列摘要

Objective: ＂Angel of Water＂ colon irrigation system is used for medical purposes, such as endoscopic and/or radiological examination, or when otherwise medically indicated. The aim of this study was to evaluate the effect, safety and satisfaction of the system. Methods: A total of 68 participants with chronic constipation were enrolled in a prospective, non-controlled, non-blinded, and non-randomized trial. All participants received 3 colon irrigations and 3 electrolyte evaluations (serum sodium and potassium level) within 2 weeks. After colon irrigation, the participants completed a questionnaire on symptoms and satisfaction. In addition, 4 participants received colonoscopy after colon preparation with irrigation twice 12 hours apart. The data of 200 person-times of colon irrigation and 196 person-time of electrolyte tests were analyzed. Results: In the 64 participants with chronic constipation, self-assessment indicated a good effect of the irrigation. 96% of the participants had stool passage after irrigation in the same day. The quality of colonic cleansing was evaluated by colonoscopy, defined as 4 grades including excellent, good, fair and poor. For participants receiving colonoscopy, 3 of 4 participants were graded as good. Regarding safety profile, no adverse event was observed in the 200 person-time colon irrigations. In addition, no electrolyte imbalance was found in the 196 person-time electrolyte evaluations. Also, no side effects such as headache, dizziness, nausea, vomiting or perianal pain, were found in the 200 person-time colon irrigation. Only few participants complained tolerable mild abdominal cramping which lasted within a short time. Conclusions: Our results indicated that colon irrigation is effective and safe for patients with chronic constipation. Participants expressed a high level of satisfaction with the procedure. Colon cleansing can also be achieved by the use of colon irrigation.

並列關鍵字

colon irrigation ； constipation ； electrolyte ； safety ； satisfaction